Organization
SERENITY SAFE HAVEN OUTPATIENT CLINIC
Active
Organization
SERENITY SAFE HAVEN OUTPATIENT CLINIC
Active
Parent organization
AGAPE STORGE HEALTHCARE SERVICES
Organization subpart
Yes
Provider details
NPI number
Legal business name
AGAPE STORGE HEALTHCARE SERVICES
Authorized official
TAHIRA S DOCKERY CRNP (CO-FOUNDER)
(267) 808-8810
Entity
Organization
Contact information
Practice address
8410 BUSTLETON AVE STE 2, PHILADELPHIA, PA 19152-1924
(267) 808-8810
Mailing address
93 OLD YORK RD STE 1-526, JENKINTOWN, PA 19046-3925
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
SP011319
PA
Other
Enumeration date
10/27/2014
Last updated
10/27/2014
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